Unresolved Issues in the Management of AF (Joint Session)-Unresolved Issues in the Management of AF (Joint Session)

Video Transcription

Video Summary

The Heart Rhythm Society 2025 held a session in San Diego focused on unresolved issues in the management of atrial fibrillation (AF). The session featured interactive presentations from notable experts, starting with Lena Rivard from the Montreal Heart Institute, who discussed the prevention of cognitive dysfunction in AF patients, especially those with device-detected AF. Her talk highlighted the connection between AF and cognitive decline, the mechanisms involved, and potential preventive treatments like oral anticoagulation and AF ablation.<br /><br />Bill McIntyre from the Canadian Heart Rhythm Society discussed the management of postoperative AF, emphasizing the importance of short-term strategies over committing to long-term anticoagulation, given the varied risks of stroke and bleeding. He highlighted the limited evidence from existing trials and called for individualized patient care.<br /><br />The session culminated with a debate on whether to anticoagulate patients with subclinical atrial fibrillation (SCAF). Emma Svenberg presented the pro argument, citing the benefits of anticoagulation in preventing severe strokes in high-risk patients, despite the increased bleeding risk. Helmut Pürfellner countered by emphasizing the low stroke risk in current practice and the increased bleeding risks, advocating for anticoagulation only in patients with significant vascular disease.<br /><br />The debate reiterated the importance of assessing individual patient risks and highlighted the need for further research to refine treatment guidelines for such patients. The session underscored the complexity of managing AF and the ongoing need for nuanced, evidence-based approaches.

Keywords

Atrial Fibrillation

Cognitive Dysfunction

Oral Anticoagulation

AF Ablation

Postoperative AF

Stroke Risk

Bleeding Risk

Subclinical Atrial Fibrillation

Individualized Patient Care

Heart Rhythm Society 2025